Favorable Modifiable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs Among Cancer Patients: The 2012–2013 Medical Expenditure Panel Survey

Singh, Jai Pal; Salami, Joseph; Warraich, Haider J.; Ogunmoroti, Oluseye; Spatz, Erica S.; Desai, Nihar R.; Rana, Jamal S.; Virani, Salim S.; Blankstein, Ron; Blaha, Michael J.; Nasir, Khurram

doi:10.1161/jaha.117.007874

Cited by 12 publications

(7 citation statements)

References 31 publications

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“…Our current study adds to the existing literature by documenting significantly lower financial hardship measures among those with a favorable CRF status. Findings from our study reiterate the advantages conferred by an optimal CRF profile beyond lower incidence and mortality from chronic diseases (including diabetes [ 18 ], cancer [ 19 , 20 ], end-stage renal disease [ 21 ], and cardiovascular disease [ 22 , 23 ]) and lower healthcare expenditures and resource utilization [ [7] , [8] , [9] , 24 ]. Our results further emphasize the importance of preventing and managing modifiable risk factors, irrespective of underlying CVD status for the overall health at individual, family, and community levels, in addition to the economic benefits at the national level.…”

Section: Discussionsupporting

confidence: 59%

“…In 2010, the American Heart Association launched the 2020 Strategic Impact Goals, which defined the concept of ideal cardiovascular health (CVH), including adequate management of hypertension, diabetes, and total cholesterol, smoking abstinence, maintaining a healthy weight and diet, and engaging in physical activity [ 2 ]. It is now well established that an optimal cardiovascular risk factor (CRF) profile, as a measure of CVH, is associated with favorable cardiovascular outcomes, including lower mortality and morbidity rates [ [3] , [4] , [5] , [6] ], as well as decreased healthcare expenditures and cardiovascular costs later in life, regardless of ASCVD status [ [7] , [8] , [9] ]. To date, however, less is known whether an optimal CRF profile is associated with lower financial hardship among affected individuals.…”

Section: Introductionmentioning

confidence: 99%

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Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States

Grandhi

Mszar

Brandt

et al. 2020

American Journal of Preventive Cardiology

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Background While optimal cardiovascular risk factor (CRF) profile is associated with lower mortality, morbidity, and healthcare expenditures among individuals with atherosclerotic cardiovascular disease (ASCVD), less is known regarding its impact on financial hardship from medical bills. Therefore, we assessed whether an optimal CRF profile is associated with a lower burden of financial hardship from medical bills and a reduction in cost-related barriers to health. Methods We used a nationally representative sample of adults between 18 and 64 years from the National Health Interview Survey between 2013 and 2017. We assessed ASCVD status and the number of risk factors to categorize the study population into 4 mutually exclusive categories: ASCVD (irrespective of CRF profile) and non-ASCVD with poor, average, and optimal CRF profile. Adjusted logistic regression model was used to determine the association of ASCVD/CRF profile with financial hardship from medical bills and cost-related barriers to health (cost-related medication non-adherence (CRN), foregone/delayed care, and high financial distress). Results We included 119,388 non-elderly adults, representing 189 million individuals annually across the United States. Non-ASCVD/optimal CRF profile individuals had a lower prevalence of financial hardship and an inability paying medical bills when compared with individuals with ASCVD (24% vs 45% and 6% vs 19%, respectively). Among individuals without ASCVD and an optimal CRF profile, the prevalence of each cost-related barrier to health was <50% compared with individuals with ASCVD. Poor/low income and uninsured individuals within non-ASCVD/average CRF profile strata had a lower prevalence of financial hardship and an inability paying medical bills when compared with middle/high income and insured individuals with ASCVD. Non-ASCVD individuals with optimal CRF profile had the lowest odds of all barriers to health. Conclusion Optimal CRF profile is associated with a lower prevalence of financial hardship from medical bills and cost-related barriers to health despite lower income and lack of insurance.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States

Grandhi

Mszar

Brandt

et al. 2020

American Journal of Preventive Cardiology

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“…The association of increased cardiovascular risk burden with higher cardiovascular mortality and death supports the notion for a better control of modifiable risk factors [11]. Importantly, better cardiovascular risk profiles are associated with lower healthcare cost and better outcomes in cancer patients [12].…”

Section: Introductionmentioning

confidence: 73%

Applications of Cardiac Computed Tomography in the Cardio-Oncology Population

Layoun

Yang

Herrmann

et al. 2019

Curr. Treat. Options in Oncol.

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Opinion statementThe increased risk for cardiovascular events in aging cancer survivors and those undergoing certain chemotherapeutic treatments has raised concern for more rigorous screening and surveillance methods above that of the general population. At this time, there are limited guidelines for how to best manage this vulnerable cohort. Questions regarding timing of screening, choice of imaging modality and risk reduction strategies-especially in those patients with known atherosclerotic disease-remain to be elucidated. Over a decade of case series, retrospective studies and clinical trials have shed light on the evolving role of cardiac computed tomography (CT) in this population, of which there is a relative paucity of data regarding its potential utility in the specific cardio-oncology population. Focusing on ability of cardiac CT to evaluate multiple cardiac and vascular structures, provide diagnostic and prognostic information, as well as assist interventional and surgical colleagues in surgical/percutaneous valve replacement and revascularization strategies is the premise for this review.

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“…CVH was determined using self‐reported traditional cardiovascular risk factors except diet. 39 Diabetes, hypertension, and hypercholesterolemia were ascertained based on self‐report. Current smoking status was self‐reported and obesity was assessed based on body mass index ≥30 kg/m 2 during pregnancy.…”

Section: Methodsmentioning

confidence: 99%

Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

Sharma

Grandhi

Acquah

et al. 2022

JAHA

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Background Suboptimal cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We aimed to evaluate the association of SDOH with suboptimal CVH among pregnant women in the United States. Methods and Results We examined cross‐sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013–2017). We ascertained optimal and suboptimal CVH based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes, hyperlipidemia, current smoking, obesity, and insufficient physical activity), respectively. We calculated an aggregate SDOH score representing 38 variables from 6 domains (economic stability; neighborhood, physical environment, and social cohesion; community and social context; food; education; and healthcare system) and divided into quartiles. We used Poisson regression model to evaluate the association of SDOH with suboptimal CVH and risk factors. Our study included 1433 pregnant women (28.8±5.5 years, 13% non‐Hispanic Black). Overall, 38.4% (95% CI, 33.9–43.0) had suboptimal CVH versus 51.7% (95% CI, 47.0–56.3) among those in the fourth SDOH quartile. Risk ratios of suboptimal CVH, smoking, obesity, and insufficient physical activity were 2.05 (95% CI, 1.46–2.88), 8.37 (95% CI, 3.00–23.43), 1.54 (95% CI, 1.17–2.03), and 1.19 (95% CI, 1.01–1.42), respectively among those in the fourth SDOH quartile compared with the first quartile. Conclusions Over 50% of pregnant women with the highest SDOH burden had suboptimal CVH, highlighting the public health urgency for interventions in socially disadvantaged pregnant women with renewed strategies toward improving modifiable risk factors, especially smoking and insufficient physical activity.

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Favorable Modifiable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs Among Cancer Patients: The 2012–2013 Medical Expenditure Panel Survey

Cited by 12 publications

References 31 publications

Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States

Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States

Applications of Cardiac Computed Tomography in the Cardio-Oncology Population

Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

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